Recurrent Pregnancy Loss

Some women can have recurring pregnancy losses, or miscarriages, because the cervix dilates early in pregnancy. This causes the pregnancy to end long before the baby is able to survive outside the womb. This problem used to be called pregnancy loss due to “incompetent cervix.” In modern times, it is referred to as pregnancy loss due to premature cervical dilation or cervical insufficiency. Either way, the loss of a pregnancy is a devastating occurrence for any woman seeking to grow her family.

For certain women with cervix-related recurrent pregnancy loss, the recommended treatment may be a special stitch that is placed around the cervix to help hold it closed during the pregnancy. This stitch is called a cerclage, and it can be placed either vaginally or via an abdominal route. Most obstetricians will place a vaginal cerclage in women with this problem but will suggest an abdominal cerclage for women who fail the vaginal cerclage, or for women whose cervix is too short to accommodate a vaginal cerclage.

Dr. Hoyte worked in conjunction with the highly experienced high-risk obstetrician, the late Dr. Valerie Whiteman, to develop a short, minimally invasive robotic technique for placing the abdominal cerclage using the da Vinci surgical system. This technique is called the Whiteman-Johnson-Hoyte Robotic Transabdominal Cerclage (WHRTAC), and it is available to women who have been diagnosed by their obstetrician with recurrent pregnancy loss due to premature cervical dilation.

The WHRTAC is placed in a way that does not disrupt the blood flow to the uterus and cervix. It can be placed either in the nonpregnant woman, or optimally, before 16 weeks of pregnancy. In order to be considered for this procedure, a woman needs to be diagnosed by a Maternal-Fetal Medicine Specialist and referred for an abdominal cerclage.